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Tribal Practices The Good Ways of Providing Mental Health & Substance Abuse Prevention, Treatment & Rehabilita

Tribal Practices The Good Ways of Providing Mental Health & Substance Abuse Prevention, Treatment & Rehabilitation Services . One Sky Center R Dale Walker, MD, Director Doug Bigelow PhD, Deputy Director Michelle Singer, Indian Country Methamphetamine Initiative Director

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Tribal Practices The Good Ways of Providing Mental Health & Substance Abuse Prevention, Treatment & Rehabilita

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  1. Tribal Practices The Good Ways of Providing Mental Health & Substance Abuse Prevention, Treatment & Rehabilitation Services One Sky Center R Dale Walker, MD, Director Doug Bigelow PhD, Deputy Director Michelle Singer, Indian Country Methamphetamine Initiative Director Laura Loudon, Mentee Project Director 10 June 2009

  2. Goal of this State Initiative: Goal of Providers of American Indian Health Services: Goal of American Indian Communities: Programs that work

  3. Practices that work: Continuous Quality Improvement Adapt-Adopt new Practices Panel Reviews Evidence Site Visit: by Previous Implementers Site Visit: Peer Review of Implementation Describe, evaluate, modify existing Practices

  4. Selecting Practices that Work—Two Routes: Imported or Home-grown Imported • Findproven practice • Adopt proven practice • Adapt proven practice for local use Home-Grown • Describe an unproven, existing,local practice • Evaluate local practice • Modify, if needed

  5. Select Tribal Practices that Work:The Native American Framework for Evidence • Approved Tribal Application form • Review Criteria/Tribal Best Practice Principles of Native American Programming Checklist • Review Panel • Review Process • 13 Tribal Practices

  6. 1. Name of Tribal Practice • Adventure Based • Canoe Journey/Family • Ceremonies and Rituals • Cradle Boards • Cultural Camp • Domestic Violence Group Treatment for Men • Family Unity • Round Dance • Sweat Lodge • Talking Circle • Tribal Crafts • Tribal Family Activities • Tribal Youth Conference

  7. Some Other Evidence-Based Native American Practices • GONA • American Indian Life Skills Curriculum • Horse Program (Equine Therapy) • Project Venture (service learning) • Family Strengthening Program • Native HOPE • Motivational Interviewing

  8. 2. Brief Description • …incorporates ceremony and ritual • …community elders…participate • Elders (transmitters of the culture)… • …youth relearning Indian cultural values… • Most tribal values incongruent with AOD abuse

  9. 3. Other examples of this Tribal Practice (Replications)

  10. 4. Evidence-basis for the Tribal Practice:Historical/Cultural Connections

  11. Historical Connections Coast Salish Canoe Journey 2008 USGS photo White Bison, Sweat Lodge in Prison http://www.whitebison.org/prisons/Reentry%20Package.pdf

  12. Longevity: the Grandmother Test Grandmother approves of the fedora…

  13. Teachings The Medicine Wheel Teachings • Harmony • Balance • Polarity • Conflict precedes clarity • The Seen and the Unseen worlds • All things are interconnected • The honor of one is the honor of all (from: White Bison, philosophy http://www.whitebison.org/about/philosophy.html )

  14. Values • Clan • Harmony • Holism • Acceptance • Taboos • Communal Property • Work as necessary • Now-orientation 

  15. Principles(e.g., Treatment of Chronic Illness) Time Healing takes time and time is healing Relationship Healing takes place within the context of a relationship. Intensity Achieving an energy of activation is necessary Holism Mental/emotional/physical Peace and Quiet The distractions of modern life "inactivate" catalysts for change Self-awareness Self-reflection needed for healing Rest Change often requires a break in usual daily rhythms. Ceremony To access spiritual aid to healing (From: Lewis Mehl-Madrona, M.D., Ph.D . Traditional (Native American) Indian MedicineTreatment of Chronic Illness: Development of an Integrated Program with Conventional American Medicine and Evaluation of Effectiveness. http://www.healing-arts.org/mehl-madrona/mmtraditionalpaper.htm )

  16. Elder’s Review-and-Approval(“Three elder women test”) E.g., White Bison begins with review and approval (blessing) of elders Coyhis Don. 1993. Meditations with the Native American Elders. Books Beyond Borders; Four Seasons. http://www.coyhispublishing.com/store.php?crn=180&rn=387&action=show_detail

  17. Community Evaluation • Cruz: “Our elders and community members will let us know if we are not doing it right.” • “Client satisfaction” measures

  18. 5. Basic Problems (or Goals) Addressed by this Tribal Practice

  19. 6. Target Population(List the primary populations to be served)

  20. 7. Factors Addressed Identify the key problem/factor(s) the practice addresses (e.g., the Community Protective Factor of “high involvement in community cultural events”, or the Individual/Peer Risk Factor of “history of prior drug use”)

  21. 8. Personnel • Elders • Medicine people • RNs • MDs • Counselors • Volunteers • Peer volunteers

  22. 9. Activities

  23. 10. Materials • Canoe • Billboards • Horses • Lodge (sweat) • Drums • School auditorium • Camp ground Sacred or hard-to-get: • Eagle feathers • Artifacts

  24. 11. OptionalElements:Other items that are not necessary to implement the program but which facilitate the Tribal Practice (e.g., food)

  25. 12. Outcomes

  26. 13. Contact person

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